Overview

• House Republicans are advancing plans to roll back the Affordable Care Act's Medicaid expansion, potentially affecting 3 to 11 million enrollees, according to projections.
• Speaker Mike Johnson has emphasized targeting 'able-bodied workers' on Medicaid, framing the cuts as a way to preserve resources for traditional beneficiaries like seniors and children.
• The rollback could devastate health systems in rural areas, with Louisiana, a major Medicaid expansion state, at risk of losing clinics and rural hospitals that rely on federal funding.
• Internal GOP divisions are growing, with lawmakers from expansion states, like Sen. Josh Hawley, expressing concern over cuts that could harm constituents and local economies.
• The House Energy and Commerce Committee is set to begin marking up the reconciliation plan in May, with Medicaid cuts central to achieving the proposed $880 billion in savings.